Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Fireproof Contractors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/28/2017 12:00 AM

Ricardo rico

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/21/2017

09/27/2017

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Boom Lift

Caulker

Knife

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

16.00

Other Work?

Other Training?

Experience

Certifications

0

No

2.00

Boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature